Common Contracts
1 similar Direct Deposit Authorization contracts
DeltaVision®Direct Deposit Authorization • March 20th, 2019
Enjoy the convenience of direct deposit by having future payments electronically deposited directly into your bank account. We will email your commission statement to the below indicated email address. I agree to accept payments through electronic funds transfer (EFT) and ensure that you can rely exclusively on the information supplied through this form. I agree to accept payments through electronic funds transfer (EFT) and ensure that you can rely exclusively on the information supplied through this form. This agreement applies to and amends all existing agreements with Delta Dental of Virginia and/or Stryden, Inc. I hereby authorize Delta Dental of Virginia and/or Stryden, Inc. to initiate credit entries to and/or debit entries from the financial institution and the account named below. Agent Information Payee Name Payee Tax ID Address Phone Email Financial Institution Information Checking Account Number Bank Transit/ABA Number Financial Institution Name City State This arrangement w
